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Is "overlap Myeloproliferative Disorder,monoclonal B-cell Lymphocytosis" A Terminal Condition?

Posted on Mon, 24 Feb 2014

Question: We would like to know whether a geriatric male with overlap myeloproliferative/myelodysplasticity disorder; monoclonal B-cell lymphocytosis; COPD; pulmonary oedema; and CCF is now likely to be terminal. Much more detailed information will be sent to YYYY@YYYY

Answered by Dr. P. C. Singh (20 hours later)

Brief Answer: I would not label this patient as terminal Detailed Answer: Hello, I have read your query and the attached reports. I would not label this patient as terminal. Something can be tried for him. Kindly let me know few more details. 1. why is his HR at 92/mt with pacemaker? 2. What is his 24 hr. urinary output? If I were the treating doctor, I would manage his fluids according to output and electrolytes. In addition you could give him 20% albumin 100 ml daily @5drops/mt for 3 days and a better antibiotic like Meropenem with sulbactam and Inj. Metronidazole only 100 ml twice daily. Thanks again...........Dr. P.C.Singh

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. P. C. Singh (14 hours later)

Thank you Dr XXXXXXX I value your expertise greatly. Unfortunately, I don't know the answer to your two questions. Could you tell me the significance of a HR at 92 with a pacemaker? Why should he have 20% albumin 100 ml daily? There is a suspicion that he has sepsis even though the blood cultures were negatiive. Why would the alternative antibiotics be better. I'm sorry to be asking all these question of you, but I am trying to gain a better understanding of the situation.